Characteristics of Household Transmission of COVID-19

Clin Infect Dis. 2020 Nov 5;71(8):1943-1946. doi: 10.1093/cid/ciaa450.


Background: Since December 2019, SARS-CoV-2 has extended to most parts of China with >80 000 cases and to at least 100 countries with >60 000 international cases as of 15 March 2020. Here we used a household cohort study to determine the features of household transmission of COVID-19.

Methods: A total of 105 index patients and 392 household contacts were enrolled. Both index patients and household members were tested by SARS-CoV-2 RT-PCR. Information on all recruited individuals was extracted from medical records and confirmed or supplemented by telephone interviews. The baseline characteristics of index cases and contact patients were described. Secondary attack rates of SARS-CoV-2 to contact members were computed and the risk factors for transmission within the household were estimated.

Results: Secondary transmission of SARS-CoV-2 developed in 64 of 392 household contacts (16.3%). The secondary attack rate to children was 4% compared with 17.1% for adults. The secondary attack rate to the contacts within the households with index patients quarantined by themselves since onset of symptoms was 0% compared with 16.9% for contacts without quarantined index patients. The secondary attack rate to contacts who were spouses of index cases was 27.8% compared with 17.3% for other adult members in the households.

Conclusions: The secondary attack rate of SARS-CoV-2 in household is 16.3%. Age of household contacts and spousal relationship to the index case are risk factors for transmission of SARS-CoV-2 within a household. Quarantine of index patients at home since onset of symptoms is useful to prevent the transmission of SARS-Co-2 within a household.

Keywords: COVID-19; SARS-CoV-2; household transmission; novel coronavirus pneumonia.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Betacoronavirus
  • COVID-19
  • Child
  • Child, Preschool
  • Cohort Studies
  • Community-Acquired Infections / transmission
  • Contact Tracing / statistics & numerical data
  • Coronavirus Infections / transmission*
  • Family Characteristics*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / transmission*
  • SARS-CoV-2
  • Time Factors
  • Young Adult